Tungiasis: a case report

This is a case report of a patient who developed a nodule in one foot, which upon biopsy, was diagnosed as tungiasis, a cutaneous infestation caused by a human flea. The natural life cycle, clinical and pathological expressions are discussed.

Epidemiology of melanoma in Puerto Rico, 1987-2002

BACKGROUND: The incidence of cutaneous malignant melanoma continues an increasing trend worldwide and has had the highest rise in incidence of all malignancies during the last decades. Mortality rates for melanoma have remained relatively stable in most countries despite the increase in incidence rates. The purpose of this study is to describe the epidemiological trends of malignant melanoma in Puerto Rico from 1987 to 2002 and to compare these findings with those previously reported for Puerto Rico as well as with those reported for other countries. METHODS: All cases of malignant melanoma reported to the Puerto Rico Cancer Registry from 1987 to 2002 were included. Age-adjusted incidence and mortality rates were calculated. Trends were compared by age, gender, anatomical location of the tumor and tumor thickness. RESULTS: There were 1,568 new melanoma cases reported between 1987 and 2002 in Puerto Rico, comprising a 50% overall increase in incidence during this period. Male to female incidence ratio was 1:0.86. The most common anatomical location in women was the lower extremity followed by the head and neck region. In men, the most common anatomical location was the trunk, followed by the head and neck region. Most of the superficial tumors (< 1mm) were located on the trunk followed by the lower limb. The most common specific histologic diagnosis reported was melanoma in situ. In 40.8% of the cases the tumor thickness value was not provided. The number of thinner melanomas (< 1mm) reported increased during the study period. Mortality rates were slightly higher for men than for women, still mortality rates remained stable for both genders and all age groups analyzed. CONCLUSIONS: Melanoma incidence rates continue to increase in Puerto Rico. This, in combination with an increase in the diagnosis of thin melanomas, suggests that the stable mortality rates may be due, in part, to earlier diagnosis and improved overall prognosis.

Disease evolution of patients with mycosis fungoides--a report of 30 cases

Mycosis fungoides is the most common disease of the primary cutaneous T-cell lymphoma group. This is a retrospective study to evaluate the outcome of 30 patients with mycosis fungoides who were followed up for at least 3 years, 18 of them followed for 5 years and 9 of them followed for 7 years. A total of 10 patients achieved a sustained remission, 2 patients achieved a remission but then relapsed and three patients died from lymphoma-related death. It is concluded that the majority of the patients with T1 or T2 stage MF usually have a good prognosis. As a rule, those who do progress further in the disease have advanced stages at the moment of the diagnosis; the disease progression occurring during the first 3-5 years after diagnosis.

The prevalence of atopic dermatitis in Puerto Rican school children

BACKGROUND: Atopic dermatitis is a common inflammatory disease of the skin that usually begins in childhood and its diagnosis depends on clinical criteria. Recent reports have indicated that the worldwide prevalence of atopic dermatitis is increasing. The objective of this study was to determine the prevalence of atopic dermatitis in schoolchildren between the ages of six and seven in two school districts in Puerto Rico. METHODS: The Laughter questionnaire, developed to determine the prevalence of atopic dermatitis in schoolchildren was translated and validated in Spanish. A population-based prevalence survey was conducted among second grade students in the districts of Guaynabo and Humacao, Puerto Rico. The prevalence of atopic dermatitis was determined by sex, school type (private or public), and geographical location (urban or rural) using the questionnaire. RESULTS: Ninety-two percent (92 %) of the eligible schools participated in the study. A total of 2,393 questionnaires were distributed with a response rate of 53 %. The prevalence of atopic dermatitis among the population surveyed was 24.8%. The prevalence of atopic dermatitis by sex or geographic location was not significantly different (p>0.05). An excess of atopic dermatitis was observed in private schools (31.0%) when compared to public schools (19.9%). The effect remained after controlling potential confounders (POR Mantel-Haenszel = 1.37; 95%CI: 1.07 - 1.42). CONCLUSION: This study presents evidence of a significant public health problem in Puerto Rico. The prevalence of atopic dermatitis in Puerto Rico is high and possibly a large percentage (70%) of the patients is not been diagnosed.

Extranodal B-cell lymphoma in a patient with atopic-like dermatitis

Atopic dermatitis is a chronic relapsing skin disease that occurs commonly during early infancy and childhood and is frequently associated to personal and family history of allergic rhinitis, asthma and/or skin disease. As a rule, it follows a benign course. We report a case of a female patient with a chronic atopic-like dermatitis who eventually developed an extranodal systemic large B-cell lymphoma during the course of her disease

Pigmented mammary Paget's disease in a man

Mammary Paget's disease is one clinical expression of an underlying breast carcinoma. It manifests as persistent erythema, oozing and scaling of the nipple, areola or both. The occurrence of this disease in men is uncommon. This is a report of a pigmented lesion of Paget's disease occurring on the breast of a man. This presentation is unusual and may be confused with melanoma. Its early recognition is important so that adequate therapy may be instituted when the disease has a favorable prognosis

Bullous pemphigoid: course of the disease. A study of 25 patients

Different studies on the course of bullous pemphigoid have suggested that there may be significant variations in the survival of these patients based on their ethnicity or region of origin. Because of the lack of studies on patients with bullous pemphigoid in the Caribbean, specifically in Puerto Rico, a retrospective analysis about the outcome of patients with this disease in the region was performed. Twenty-five (25) patients were included in this study. The patients were diagnosed as bullous pemphigoid by clinical, histopathologic and immunopathologic assessment. Medical records were reviewed and those patients that were alive were contacted and examined on a follow up visit. Nine were men and sixteen were women; the age at the time of the diagnosis ranged from 54 to 90 year-old (mean 72); 13 were alive after at least 5 years of follow-up and 12 had died. The age at the moment of death ranged from 67 to 95 year-old (mean 83). Of those patients living, 85 were in remission, while 15 had active disease. In general, patients had a disease of mild severity, but, still, 68 of them received systemic corticosteroid therapy. Five of patients had to be admitted due to disease; two of them died while at the hospital. This data suggests that bullous pemphigoid in Puerto Ricans is a disease with a relatively benign course, but which can be fatal in the elderly, especially, if it requires admission to the hospital and the patient receives high doses of systemic corticosteroids

Esclerosis múltiple: aproximación epidemiológico-genética en habitantes de Antioquia, Colombia. II: desequilibrio de ligamento al HLA DQÓ / Multiple sclerosis: an epidemiologycal approach in Antioquia, Colombia. II: Linkage desequilibrium to HLA, locus DQÓ

La discriminación y cuantificación de los componentes ambientales y genéticos en el desarrollo de esclerosis múltiple (EM) no se ha podido realizar. con la finalidad de acercarnos a la discriminación de dichos componentes, hemos analizado casos afectados de EM a partir de la comunidad paisa de Antioquia, Colombia, zona situada en el trópico; para detectar un posible desequilibrio de ligamiento al HLA, locus DQÓ, aspecto que revelaría la importancia del componente genético en el desarrollo de EM. Un análisis de contingencia entre las distribuciones genotípicas del HLA DQÓ de los casos y controles, usando el remuestreo de Monte Carlo para solucionar el problema del tamaño muestral que es inherente a las poblaciones con baja prevalencia de EM, reveló que existen diferencias significativas entre las dos distribuciones. La tendencia alélica observada fue de un incremento de los alelos 1.1., 1.2 y una disminución de los alelos 3 (con un p significativamente < de 0,05) y 4 en la población afectada. Los mismos resultados han sido descritos en otras poblaciones de origen caucasoide no localizadas en el trópico, lo cual puede indicar que este componente genético descrito en la población caucasoide se ha mantenido en la poblaciòn de enfermos con EM originarios de Antioquia y que continúa siendo importante para el desarrollo de la enfermedad

Idiopathic epilepsy with generalized tonic clonic seizures in Antioquia, Colombia: is the joint Amerindian and Negroid racial admixture the cause of its high prevalence?

Most Colombian populations stem from the admixture of Caucasians, Amerindians and Negroids. In the world, these two latter ethnical groups show a significantly higher prevalence of epilepsy than the former one. We tested the hypothesis that the high prevalence of idiopathic epilepsy with generalized tonic clonic seizures found in the Antioquian population (Paisas), from Colombia, is due to their possible joint Negroid and Amerindian ethnic components. We have previously demonstrated that inheritance is the principal factor for developing epilepsy in this community. Analyses of racial admixture, heterogeneity between populations, genetic distance, and phyletic relationships were performed among epileptic and non epileptic samples from the Antioquian community. Also Caucasians, Spaniards, Basques, Jews, Chileans, Negroids, Amerindians and Mongoloids were included in the analysis. Four highly polymorphic blood systems were used as genetic markers: RH, MNS, ABO and FY. They were chosen because of their high discriminant power in these ethnic groups. In the population affected with idiopathic epilepsy, the estimated Negroid and Amerindian rates of admixture were low (3 percent and 14 percent, respectively). Although, these degrees of admixture can be explained due to common ancestral origins, the estimated proportion of Amerindian admixture in the epileptic affected population, was significantly higher than the estimated for the Non affected Antioquian population. The latter finding is consistent with the analysis of heterogeneity between populations that discriminated epileptic population from non epileptic Antioquian population (p < 0.05). Epileptic and non epileptic Paisas clustered in topology with Caucasians, very close to Spaniards and Basques and highly distant from Negroids and Amerindians. Thus, far, the origin of the high prevalence of idiopathic epilepsy in the Antioquian (Paisa) population cannot be explained by the hypothetical joint Negroid and Amerindian ethnical admixture, but using additional genetic markers and other methods of racial estimation of admixture it is necessary to corroborate if the Amerindian admixture component is significantly higher in the epileptic population than in the non epileptic Paisa population

Acción sobre haemophilus influenzae de su ácido desoxirribonucléico transformante irradiado in vitro con luz ultravioleta a -70- / Action on haemophilus influenzae of its transforming deoxyribonucleic acid irradited in vitro with ultraviolet light at -70-C

La irradiación con luz ultravioleta a - 70-C de DNA transformante desnaturalizado, el cual fue posteriormente sonicado y renaturalizado con DNA no irradiado, así como el DNA no irradiado y sometido a los otros tratamientos, provocaron un fuerte efecto letal sobre H. influenzae, el cual fue detecto al efectuarse la cuenta viable de las mezclas de transformación, encontrándose la disminución de la viabilidad de las células de un 98% para el caso del DNA irradiado y de un 97.2% para el DNA sin irradiar. Pensamos que la letalidad pueda deberse, tanto a la integración al genóforo de la célula receptora de los marcadores letales provados por la luz UV, como a la activación de un fago defectuoso causada por la penetración del DNA transformante irradiado o no con luz UV. La irradiación con luz UV del DNA transformante desnaturalizado, el cual fue renaturalizado consifo mismo, hizo aumentar ligeramente el número de mutantes resistentes a Kanamicina en células competentes de H. influenzae. Al someterse a lisis sónica del DNA irradiado, antes de renaturalizarse con DNA no irradiado, el resultaod obtenido fue aproximadamente el mismo que en el caso anterior. Sin embargo, cuando el número de mutantes resistentes a novobiocina se corrigió por la cuenta viable de la mezcla de transformación y el efecto mutagenético se cuantificó con relación a las frecuencias de mutación, encontramos un aumento de dichas frecuencias de 74 veces respecto a los testigos de células no tratadas con DNA. Este efecto puede, en principio, deberse a la integración en el genoma receptor de las lesiones mutagenéticas causadas por la irradiación con luz UV a - 70-C del DNA transformante, mas la afirmación concluyente de esto, requerirá la demostración de que dicha integración se lleva a cabo. Proponemos que estas lesiones mutagenéticas pudieran ser del tipo 5-timinil-5, 6-dihidrotimina. Fue interesante que del SNA no irradiado con luz UV, provocara también un aumento aunque menor al producido por el DNA irradiado, de las frecuencias de mutación. La explicación de este hecho, necesitará de un análisis experimental detallado posterior, utilizando mutantes rec y uvr de H. influenzae